Positive outcomes in the previous year health initiatives have inspired us to continue with the similar strategy in this year too. The overwhelming enthusiasm & participation of community in the monitoring of health programs, have proved our method correct. The health department also accepted the people’s verdict in a positive way. Amidst the celebration of relative progress towards making the healthcare available at the doorstep of rural inhabitants, we swallowed the sorrow of zero mental health services in the entire region. We also could not afford to shelve our expertise in malaria control intervention. Especially, when the fresh surveillance worker recruits are confused in the community and at the same time facing the disheartening scenario of many deaths due to malaria. All these have shaped our health agenda in two directions of giving and asking. The agenda of giving health agenda also emerged from the experience that despite untiring effort by health personnel after emergence of NRHM the gaps that existed since decades in the health system could not be corrected in just the span of few years. Hence, we placed our health intention towards playing mixed role of giving & asking health.
Our Health & Health is for Us:
The process of asking health do not stop in demanding health, it also means owning health. It involves enabling the community to ask for their entitlement guaranteed under different health scheme. It also means imbibing transparency and accountability in the health system. Farther, it denotes taking ownership of the health facilities created by the government.
The Accredited Social Health Activist (ASHA) has been the most effective innovation in the National Rural Health Mission. Though many a times the confusion crops up in understanding whether they are last rank cadre in the health system or community appointed activist to ensure community’s health entitlement? For us, latter one is the priority, yet we made enormous effort to make them skilled in first one too. With these intentions more than 100 ASHAs under Debitola & Gossaigaon Development Block are trained on health rights and primary healthcare.
The trained ASHAs are motivated to join already formed Porbotjora ASHA Association. The ASHA association formed by NERSWN is now well functioning one. They hold once a month meeting to share their joy & pain and discuss & decide upon their course of action. They also discuss about the problems of health care in their jurisdiction. Based on democratic discussion resolutions are taken and same is submitted to the higher authorities of health department for necessary corrective action. The individual ASHAs are now strengthened with the collective empowerment. The actions are taken collectively and NERSWN has always stood firmly with them. As a result, their complain such as behavior of doctor, un-official charges, irregularities in disbursing ASHA incentives etc. have been successfully resolved in favour of ASHAs by the higher ups of Health Department.
Another good innovation under National Rural Health Mission is formation of Village Health & Sanitation Committee (VHSC). The rural masses that were totally invisible in health program planning and implementation has now found formal place in the system. Taking advantage of the same, NERSWN in order to effectively facilitate participation of village community in healthcare programs, have trained representatives of all the members of VHSC under Debitola Development Block. After training the VHSC members, the NERSWN tram has organized village meetings in the villages to create awareness about the health entitlements under the NRHM and other vertical health programs. The NERSWN team also had held meeting with women groups, village councils and so on. As a result, under the development block the immunization services, disease surveillance, institutional care etc. have shown considerable improvement which was evident during the public dialogue. The health personnel in the are who were least monitored are now are were that they are been watched closely on their activities and the same is reflected in their action.
With the Hospital Management Committees and Rogi Kalyan Samitis NERSWN has organized orientation meeting and also had one to one interaction. Through this group and one to one conversations the committee members are made aware about their role and responsibilities. As a result the untied funds are utilized in more democratic way and punctually of health care personnel in their duties has shown upward progress.
Besides, orientation and training on different issues, members of these committees were trained on community monitoring processes & tools. After training the NERSWN also has facilitated in the initial monitoring works of these institutions.
All these enabling processes have finally culminated in to one Public Dialogue under the block. In the Public Dialogue the district heads of health department such as Jt. Director, Block Program Manager and all PHC in-charge were present. There was huge presence of villagers both women & men.
In the public Dialogue the findings of the Community Monitoring was shared with the health authorities. The testimonies of people were also shared. Some of the adverse experiences were also shared by the people. Based on the findings and testimonies the Jt. Director has responded by owning responsibilities of all the loopholes and promising to improve the delivery of services in future. He also admired the people’s participation in monitoring the health programs and sought similar commitment in future too so that healthcare could be made available even to the last person.
The exercise was really meaningful. Being the first one it is really motivating. For NERSWN team it was meaningful not only for health but in many ways. Because, such democratic & congenial dialogue between the government department and people are really rare in this conflict ridden region. Hence apart from strengthening health system it also has contributed towards strengthening the democratic values and spirit in a region marked by conflict and poor governance.